Have you ever started a weight loss program only to stop before you achieve a noticeable weight reduction?
Do you ever criticize yourself for giving in to cravings? to hunger?
Ever given up because of self-doubt, or belief that you cannot be a success?
Do you believe that thinner people had some type of inner control or strength that you are lacking?
A frequently unrecognized barrier to weight-loss and long-term weight stabilization is internalized weight bias. Children and adults living with larger bodies repeatedly experience negative signals about their body’s size. These negatively biased signals can be from–media, peers, family, teachers, and medical providers.
For some it starts as early as nursery school. We are surrounded with messages that imply a larger body size reflects multiple negative personal attributes or traits. Television shows, animated cartoons, and social media frequently suggest that heavier people have lower intelligence, less motivation, or decreased self-control. Suggesting that if our bodies are large, we must be deficient in the attributes needed to become a thinner person. Heavy characters often may be portrayed as poor at sports, unsuccessful at work or romance and being of a lower intellect. Larger people are hurt, traumatized and ostracized by these ubiquitous signals. These are examples of “fat shaming” and weight bias.
What happens if we internalize these negative messages into our self-talk? Internalized weight bias has been shown to happen as early as age 5 or 6. This internalization molds our self-talk (internal dialogue—that inner voice). These voices are powerful and persuasive. They degrade, criticize, and humiliate us. People living with the chronic disease of Obesity are frequently affected by this internalized bias.
The negative internal dialogue may cause repeated harm. It stresses that their real or perceived missteps or inappropriate actions are again signs of weakness and/or poor behavior. Over time internal dialogues can focus on repeated failures, having no “will”, being a food “junky” and many more descriptions which lead to apathy, anxiety, and depression. The obvious outcome easily will be just giving up, feeling beaten down and sadly this often increases unhealthy behaviors. This increase may be eating “comfort foods”, excessive snacking, or possibly, binge eating. They may include depression, retreating from social interactions, or losing motivation to take care of oneself with exercise, adequate sleep, and healthy eating.
Self-efficacy, the belief that you can accomplish something you want to accomplish, is undermined by this internal self-bias. Can you successfully lose weight and keep on track with healthy behaviors if you feel beaten down, depressed, or ashamed?
Working with Obesity medicine professionals (physicians, psychologists, registered dietitians, and others) who understand the negative effects of internalized bias will help improve your success and your sense of self-efficacy. The chronic disease of Obesity should never be treated with the bias adage of “eat less and move more”. Addressing the behavioral/psychological needs of our patients living with obesity is basic to quality medical care in this disease. GMOS clinic came into being because of my desire to spend time with and listen to my patients. People with obesity deserve one on one time for help with stress and emotional barriers. This help is part of our treatment which focuses on helping all patients have a foundation of education and treatment of their nutritional, behavioral, pharmaceutical, and psychological needs.